Yarning up the Indigenous Navigator Model

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Indigenous Health Services Yarning up the Indigenous Navigator Model Dean Johnson Indigenous Health Coordinator

Population Health Local Government Areas: Ipswich City Council, Scenic Rim Regional Council, Somerset Regional Council, Lockyer Valley Regional Council. In 2011-12, the average life expectancy at birth for West Moreton residents was 80.7 years and in the period 2009-2011 there were 176 deaths per 100,000 people that were potentially avoidable. Within West Moreton s population approximately: 71% of the population are overweight or obese 38% of the population are obese 19% of the population smoke daily 14% of adults face a cost barrier to seeing a medical specialist 9% of adults face a cost barrier to filling a prescription

WMHHS Population Profile 2036 = 637,000 2012 = 252,000 West Moreton's expected population increase is in excess of 150%, making West Moreton the fastest growing hospital and health service in Queensland. By comparison, Queensland as a whole is projected to increase approximately 60% in the same period.

Steady rise in activity Activity flowing through the health service has been steadily increasing, driven by significant population growth and local health demographics. Presentations to the Emergency Department alone have increased by over 20 percent during the past three years. Ipswich Hospital Emergency Department presentations January 2012 to August 2015

Improving Our Services Over the past several years West Moreton has dramatically improved the timeliness and manner in which our patients are able to access healthcare. Since November 2014, there have been no elective surgery patients waiting longer than is clinically recommended the first time in history. The Specialist Outpatients Department reduced long wait lists from over 5,387 patients waiting in July 2014, to just over 100 patients waiting in June 2015. Patients are being cared for in a safer manner, with the introduction of a 24 hour model of care.

Five Disruptive Forces Affecting Health Care The Lifestyle Epidemic The Information Revolution The Blessing and Curse of Clinical Technology The Greying Patient (and provider) The New Health Care Consumer

What is our future of healthcare provision? Status Quo? Innovative new models of care that are built around the patient. Population Health Approach? Alternative Innovation?

Closing the Gap : Queensland Indigenous Life Expectancy Gap - What does it look like? COAG agreed the gap in life expectancy between Indigenous and non-indigenous Australians must be closed. COAG agreed to a partnership between all levels of government to work with Indigenous Communities to achieve the target of closing the gap on Indigenous disadvantage. COAG committed to: 6% 6% 7% 11% 5% 3% 5% 10% 21% 11% 15% Cardiovascular disease Diabetes mellitus Mental disorders Chronic respiratory disease Intentional injuries Malignant neoplasms Unintentional injuries Infectious and parasitic diseases Neonatal causes Acute respiratory infections Other - Closing the life expectancy gap within a generation; - Halving the mortality gap for children under five within a decade; and - Halving the gap in reading, writing and numeracy within a decade. COAG has also agreed that States and Territories will report transparently on the use of their Commonwealth Grants Commission funding which is on the basis of Indigenous need funding for services to Indigenous people. Life expectancy at birth (years) 2005-2007 2010-2012 Change 2005-2007 to 2010-2012 Indigenous Non-Indigenous Gap Indigenous Non-Indigenous Gap Indigenous Non-Indigenous Gap Males Qld 67.1 78.8 11.8 68.7 79.4 10.8 1.6 0.6-1.0 NSW 68.3 78.8 10.5 70.5 79.8 9.3 2.2 1.0-1.2 WA 64.5 79.2 14.7 65.0 80.1 15.1 0.5 0.9 0.4 NT 61.5 75.5 14.0 63.4 77.8 14.4 1.9 2.3 0.4 Aust (a) 65.7 78.9 13.1 67.4 79.8 12.4 1.7 0.9-0.7 Females Qld 72.7 82.7 10.0 74.4 83.0 8.6 1.7 0.3-1.4 NSW 74.0 82.6 8.6 74.6 83.1 8.5 0.6 0.5-0.1 WA 70.0 82.9 12.9 70.2 83.7 13.5 0.2 0.8 0.6 NT 69.4 81.0 11.6 68.7 83.1 14.4-0.7 2.1 2.8 Aust (a) 71.7 82.7 11.0 72.3 83.2 10.9 0.6 0.5-0.1

Making Tracks towards closing the gap in health outcomes for Indigenous Queenslanders by 2033 Making Tracks provides a long term evidenced based policy consistent with COAG s Indigenous Reform Agreement to which the Queensland Government remains committed. The framework articulates the vision for closing the gap in Indigenous disadvantage by 2033 Queensland Health Aboriginal and Torres Strait Islander Cultural Capability Framework 2010-2033 : Queensland Health shares the vision of closing the life expectancy gap between Aboriginal and Torres Strait Islander and other Queenslanders. To achieve this, we need to ensure that our organisation is well positioned to meet the needs of Aboriginal and Torres Strait Islander peoples. This relies on much more than the provision of clinical services. It also requires an organisation that understands and respects cultural differences and needs, and applies this understanding and respect in its governance, policy, planning, infrastructure, funding, standards, information systems, human resource management, quality improvement, education, training and every aspect of health service delivery.

WMHHS Cultural Capability Plan The objective of the WMHHS Cultural Capability Plan is to ensure that: WMHHS is aligned with relevant National policies and priorities for health. All Aboriginal and Torres Strait Islander focussed activities, services and processes across the Organisation are working towards the same goals Describes the relationships between strategic and operational plans, translating into activities at the frontline of health services. The provision of health services locally has clear priorities, supportive leadership and staff who work both together and across each level of the health system. Effectively fulfilling our vision and addressing our challenges, with all staff having have a clear understanding of where we are heading, how we are going to get there, and how day to-day role supports the overall achievement of our goals.

Indigenous Health Services

Indigenous Navigator Model Coordination is the Care All patients and their families must be treated with kindness, respect and dignity and the way we experience care should be valued both from a clinical treatment perspective and cultural appropriateness of service delivery. High Risk: People with complex, unstable and often co morbid conditions who are at very high risk of hospitalisation and receive intensive care coordination (5% of the population). Care Coordinators Medium Risk: People who are at high risk of hospitalisation who need help managing their chronic condition through care navigation and selfmanagement support such as health coaching (15-35% of the population). Navigators Low Risk: 70-80% of people with chronic conditions who are in control of their condition and are able to self-manage with limited support. Health Coaches

Numbulli Yalwa Project Program Artwork By Ms Leanne Ruska, is called Yuggilinair Murra Murra meaning (Working Hand in Hand). It represents Aboriginal and Torres Strait Islanders on their journey, depicting their inner spirit which gives strength to walk out into our communities and work with health professionals to give our community access to health care that helps patients maintain a healthier, longer and productive life.

Numbulli Yalwa Project Health Service Planning Through E-Shared Patient Files Improve planning and coordination of Aboriginal and Torres Strait Islander primary health care services across West Moreton Contribute to better long-term health outcomes for Aboriginal and Torres Strait Islander patients Improve Aboriginal and Torres Strait Islander population health reports across West Moreton

Numbulli Yalwa Project Project Launch 19 August 2015 Partnership Walk Art work unveiling Nunukul Yuggera Aboriginal Dancers Bush Tucker Lunch QT, media release and radio Mabuiag Islander Dancers

Patient Care West Moreton Hospital & Health Service Our Communities

WMHHS Community Engagement